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Organization
CODY DENTAL CENTER P.C.
Active
Organization
CODY DENTAL CENTER P.C.
Active
Other names
Dr. Karen E. Eggleston
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN E. EGGLESTON D.D.S. (OWNER)
(248) 395-4700
Entity
Organization
Contact information
Practice address
17070 W 12 MILE RD, SUITE C, SOUTHFIELD, MI 48076-2116
(248) 395-4700
Mailing address
17070 W 12 MILE RD, SUITE C, SOUTHFIELD, MI 48076-2116
(248) 395-4700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13102
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J131020
BLUE CROSS BLUE SHIELD
MI
Enumeration date
01/15/2007
Last updated
04/24/2008
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